Subinternship in Anesthesiology

Course Number: AN350.01

The UCLA Department of Anesthesiology and Perioperative Medicine offers a three week Subinternship in Anesthesiology to fourth year UCLA and visiting medical students. The rotation is offered throughout the year (July through June) for up to a maximum of eight medical students per rotation. During this rotation, medical students work primarily in the operating rooms at the Ronald Reagan UCLA Medical Center alongside dedicated and accomplished residents and attendings. One week of the rotation is spent either at the UCLA Ambulatory Surgery Center or the Santa Monica UCLA Medical Center and Orthopaedic Hospital. During our Subinternship in Anesthesiology, students participate in the preoperative, intraoperative, and postoperative evaluation and anesthetic management of patients undergoing general surgery, cardiac surgery, head and neck surgery, interventional radiology, invasive medical procedures, liver transplantation and other visceral organ transplant surgery, neurosurgery, obstetrics and gynecology procedures, opthomalogy procedures, orthopedic surgery, pediatric surgery, thoracic surgery, urologic procedures, and vascular surgery.

Medical students enrolled in this course are oriented by the medical student coordinator and clerkship director on the first day of the rotation. During this orientation, students attain basic intubation and IV catheter training. Additionally, rotating medical students participate in a series of structured didactic lectures, case conferences, workshops, and simulation sessions, designed to enhance the students’ skills and knowledge in the area of anesthesiology. Moreover, students attend the Department's weekly Grand Rounds, which showcase highly interesting topics of clinical relevance by expert UCLA physicians as well as visiting professors from other institutions. Of particular note, students enrolled in this course are given the opportunity to work on the Human Patient Simulator during their rotation. This is a sophisticated device used to simulate clinical scenarios that range from basic and commonly encountered situations, such as alternative airway management, to very complex medical problems, such as sepsis and high-output cardiac failure. Students also take evening and overnight calls to take advantage of education opportunities available in the evening that typically vary throughout the day.

Learning Objectives

Our Subinternship in Anesthesiology emphasizes the introduction of basic concepts in anesthesiology in both the in-patient and out-patient setting. Specific learning objectives include:

  • Clinical physiology and pathophysiology
  • Principles of clinical pharmacology
  • Preparation of patients for anesthesia and surgery
  • Introduction to the management of anesthesia for subspecialty surgery.
  • Airway management (control of airway with mask ventilation, endotrachael intubation, alternative airways, etc).
  • Introduction to the principles and techniques of general and regional anesthesia
  • Introduction to the practical pharmacalogy of sedatives, narcotics, and local anesthesia.
  • Introduction to monitoring (EKG, BP, pulse oximetry and invasive monitors).
  • Experience in establishing lines: IV, CVP, Swan-Ganz, and arterial lines.
  • Introduction to opiates and pain management
  • Introduction to critical care and postoperative recovery room management (resuscitation, IV fluid management, mechanical ventilation, reversal of anesthetics, etc)

Expectations and Checklist Card

Medical students are expected to review and follow the expectations set forth by the Department. A list of expectation is distributed during orientation. In addition, medical students are issued a checklist card during orientation. The checklist card highlights procedures to be performed and topics to be discussed with residents and attendings throughout the rotation. The resident or attending should initial the checklist card for that particular item once it has been completed. This should be submitted to the Medical Student Education Coordinator on the last day of the rotation.

Reading Material

Suggested reading includes chapters from Basic of Anesthesia, 6th edition, by Ronald D. Miller, MD and Manuel Pardo, MD. Medical students may check out copies of this introductory text from the Medical Student Education Coordinator. A reading syllabus is provided during orientation.

Schedule

Typical Weekly Schedule

Hour Monday Tuesday Wednesday Thursday Friday
AM 8:00 - 10:00*
Anesthesiology Orientation
Intubation Training
IV Catheter Training
(only on 1st day;
other Mondays - Operating Room)

9:00 - 12:00*
Operating Room
*Times may vary
pending Visiting Medical Student
CareConnect Training Course
6:30 - 12:00
Operating Room
7:00 - 8:00
Grand Rounds

8:30 - 12:00
Operating Room
6:30 - 12:00
Operating Room
6:30 - 12:00
Operating Room
PM 12:00 - 16:00
Operating Room
12:00 - 15:30
Operating Room

15:30 - 17:00
Didactics
12:00 - 16:00
Operating Room
12:00 - 16:00
Operating Room
12:00 - 16:00
Operating Room

Medical students are expected to stay at least until 3:00pm every weekday. If the medical student is involved in an interesting learning case, he or she is encouraged to stay longer to see the case through to its end. Medical students are also required to take evening and overnight calls to take advantage of education opportunities available in the evening that typically vary throughout the day. As our Subinternship in Anesthesiology is an excellent opportunity to gain knowledge and clinical training in the discipline, it is very important to be in attendance every day as scheduled. Medical students are encouraged to plan their rotation around this expectation. Any anticipated absences must be approved by the Medical Student Education Coordinator and Clerkship Director prior to the start of the rotation.

Exam

A written post-rotation exam will be administered on the last day of the rotation. It is designed to evaluate the quality of the educational experience for the medical student. Medical students may use the reading syllabus as a general outline of the types of topics that will be covered on the exam.

Evaluations

Residents and attendings evaluate medical student performance formally, but are also encouraged to give verbal feedback to the medical student. Evaluations are compiled into a summative evaluation and reflected in the Medical Student Performance Evaluation. For confidentiality purposes, residents and attendings will submit these evaluations directly to the Medical Student Education Coordinator, but are encouraged to give verbal feedback to the medical student.

Medical students are encouraged to complete evaluations on residents and fellows in order to provide confidential and anonymous feedback. Residents and fellows receive these evaluations in redacted form on a quarterly basis. Residents and fellows utilize these evaluations to assess and improve their practice performance. These evaluations should be submitted to the Medical Student Education Coordinator on the last day of the rotation.

Medical students are encouraged to complete an evaluation on the overall rotation. This evaluation will provide feedback to the Medical Student Education Coordinator and Clerkship Director about the quality of the educational experience for the medical student. We constantly look for opportunities to improve our educational programs in order to provide the best possible learning environment for all of our trainees and we appreciate your feedback.

Visiting medical students who are interested in pursuing a rotation in the UCLA Department of Anesthesiology and Perioperative Medicine may apply through VSAS, the Visiting Student Application Service. To obtain information about the David Geffen School of Medicine at UCLA's supplemental document requirements, application deadlines, and fees, or to view detailed elective course descriptions, please visit http://medschool.ucla.edu/current-visiting-students.

If you have any questions, please contact the Medical Student Coordinator, Susan Kim, either by phone at (310) 267-8667 or via email at SMKim@mednet.ucla.edu.